title: Routine aspiration of subglottic secretions after major heart surgery: impact on the incidence of ventilator-associated pneumonia.
abstract: Aspiration of subglottic secretions (ASS) is recommended in patients requiring mechanical ventilation for ≥48h. We assessed the impact of the introduction of ASS routinely in all patients after major heart surgery in an ecological study comparing ventilator-acquired pneumonia (VAP) incidence, days of mechanical ventilation, and cost of antimicrobial agents before and after the implementation of ASS. Before and after the intervention the results (per 1000 days) were: VAP incidence, 23.92 vs 16.46 (P = 0.04); cost of antimicrobials, €71,384 vs €63,446 (P = 0.002); and days of mechanical ventilation, 507.5 vs 377.5 (P = 0.009). From the moment of induction of anaesthesia all patients undergoing major heart surgery should routinely receive ASS.
authors.affiliation: Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Ciber de Enfermedades Respiratorias (CIBERES), Madrid, Spain. Electronic address: massus@hotmail.es.
authors.forename: M J
authors.initials: MJ
authors.lastname: Pérez Granda
authors.forename: J M
authors.initials: JM
authors.lastname: Barrio
authors.forename: J
authors.initials: J
authors.lastname: Hortal
authors.forename: P
authors.initials: P
authors.lastname: Muñoz
authors.forename: C
authors.initials: C
authors.lastname: Rincón
authors.forename: E
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use; D012634:Bodily Secretions; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000517:prevention & control*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D013396:Suction / Q000379:methods*; D013903:Thoracic Surgery; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents
keywords: Aspiration of subglottic secretions; Intensive care; Major heart surgery; Prevention; Ventilator-associated pneumonia